2009 CALIFORNIA STRENGTH OPEN

2009 CALIFORNIA STRENGTH OPEN ENTRY FORM

Please complete this form and mail it with your entry fee of $45.00 For Seniors and Masters - $25.00 For Juniors by September 19th, 2009.

Please make checks payable to California Strength. Send entries to:

California Strength
Att: Matthew Johnson
2021 Omega Road, Suite 120
San Ramon, CA 94583

I agree by signing this form for the 2009 California Strength Open (USAW/PWA #38-09-09), that I will abide by all of the rules of USA Weightlifting (USAW) and the Pacific Weightlifting Association (PWA). I will not hold responsible USAW, the PWA, the Officials and Organizers of this event or California Strength for any injuries that may happen to me while competing in, or while traveling to and from this event.
I (and my parent or guardian if I am a minor) agree to be filmed and photographed at the venue, to include the use of my name, biographical information, interviews, photographs, portrait and motion pictures and television recordings of my weightlifting performance and grant to the Organizers the right to record and make use of the same, and to authorize others to do so in promoting the competition and the success of the weightlifting team on which I compete, to promote the sport of Weightlifting, and to fund the activities of the California Strength and the PWA.
SIGNATURE_______________________________________________ DATE_________________ SIGNATURE OF PARENT (IF UNDER 18 YEARS OLD)___________________________________ PLEASE PRINT THE FOLLOWING VERY CLEARLY: NAME____________________________________________ PHONE #(____)_______________ ADDRESS________________________________________CITY________________ZIP_______ EMAIL ADDRESS________________________________________________________________ BODYWEIGHT CLASS_____________________KG YEAR OF BIRTH _____________________ MALE/FEMALE _________ T-SHIRT SIZA (CHOOSE ONE): S_____ M_____ L_____XL______ CURRENT USAW CARD NUMBER_______________ EXPIRATION DATE____________________ USAW CLUB_____________________________________________________________________ YOU MUST HAVE A CURRENT USA WEIGHTLIFTING MEMBERSHIP TO COMPLETE THIS ENTRY. Any questions may be directed to Matthew Johnson (925) 385-8877


Please complete this form and mail it with your entry fee of $45.00 For Seniors and Masters - $25.00 For Juniors by September 19th, 2009.

Please make checks payable to California Strength. Send entries to:

	California Strength Att: Matthew Johnson 2021 Omega Road, Suite 120 San Ramon, CA 94583



I agree by signing this form for the 2009 California Strength Open (USAW/PWA #38-09-09), that I will abide by all of the rules of USA Weightlifting (USAW) and the Pacific Weightlifting Association (PWA). I will not hold responsible USAW, the PWA, the Officials and Organizers of this event or California Strength for any injuries that may happen to me while competing in, or while traveling to and from this event. I (and my parent or guardian if I am a minor) agree to be filmed and photographed at the venue, to include the use of my name, biographical information, interviews, photographs, portrait and motion pictures and television recordings of my weightlifting performance and grant to the Organizers the right to record and make use of the same, and to authorize others to do so in promoting the competition and the success of the weightlifting team on which I compete, to promote the sport of Weightlifting, and to fund the activities of the California Strength and the PWA.
SIGNATURE_______________________________________________ DATE_________________ SIGNATURE OF PARENT (IF UNDER 18 YEARS OLD)___________________________________ PLEASE PRINT THE FOLLOWING VERY CLEARLY: NAME____________________________________________ PHONE #(____)_______________ ADDRESS________________________________________CITY________________ZIP_______ EMAIL ADDRESS________________________________________________________________ BODYWEIGHT CLASS_____________________KG YEAR OF BIRTH _____________________ MALE/FEMALE _________ T-SHIRT SIZA (CHOOSE ONE): S_____ M_____ L_____XL______ CURRENT USAW CARD NUMBER_______________ EXPIRATION DATE____________________ USAW CLUB_____________________________________________________________________ YOU MUST HAVE A CURRENT USA WEIGHTLIFTING MEMBERSHIP TO COMPLETE THIS ENTRY. Any questions may be directed to Matthew Johnson (925) 385-8877